Redefining Perioperative Care: The Pivotal Role of Anesthesiologists in Enhanced Recovery After Surgery (ERAS) Protocols
Muhammad Faraaz Ismail*, Raji Sharma
Abstract
Background: Enhanced Recovery After Surgery (ERAS) protocols are comprehensive, evidence-based pathways designed to optimize perioperative care and improve patient outcomes by minimizing surgical stress, maintaining physiological stability, and expediting functional recovery. These protocols span preoperative, intraoperative, and postoperative phases, integrating strategies such as multimodal analgesia, goal-directed fluid therapy (GDFT), and early ambulation. The anesthesiologist plays a pivotal role in ensuring the successful implementation of ERAS protocols, contributing to effective pain management, hemodynamic stability, and reduced postoperative complications. Objective: This narrative review aims to critically analyze the evolving role of anesthesiologists within ERAS protocols, highlighting their contributions to optimizing perioperative care and improving surgical outcomes. Methods: A comprehensive review of key references on ERAS protocols was conducted, synthesizing data from peer-reviewed articles, clinical studies, and ERAS guidelines. The extracted information was organized according to a structured outline, focusing on the preoperative, intraoperative, and postoperative phases of anesthetic care within ERAS pathways. Findings: Anesthesiologists contribute significantly to each phase of ERAS implementation. In the preoperative phase, they lead patient education, prehabilitation, and anesthetic planning. During surgery, they implement multimodal analgesia, regional anesthesia, and GDFT to minimize opioid use and maintain euvolemia. Postoperatively, anesthesiologists support early ambulation, non-opioid pain control, and prevention of postoperative nausea and vomiting (PONV). Innovations such as point-of-care ultrasound (POCUS), artificial intelligence (AI)-driven decision support, and novel anesthetic agents are enhancing the efficacy of ERAS protocols. However, challenges remain, including institutional barriers, resistance to opioid-sparing techniques, and the need for improved multidisciplinary collaboration. Conclusion: The anesthesiologist’s role in ERAS extends beyond intraoperative management to encompass leadership in multidisciplinary care and patient-centered recovery. By addressing barriers to ERAS implementation and embracing technological advancements, anesthesiologists can drive innovation and enhance perioperative outcomes. Continued research, education, and collaboration are essential to further standardize ERAS protocols and promote global adoption, ensuring optimal surgical care and improved patient experiences.
Keywords
enhanced recovery after surgery (ERAS); anesthesia; multimodal analgesia; perioperative care; fluid management; regional anesthesia.
Cite This Article
Ismail, M. F., Sharma, R. (2025). Redefining Perioperative Care: The Pivotal Role of Anesthesiologists in Enhanced Recovery After Surgery (ERAS) Protocols. International Journal of Scientific Advances (IJSCIA), Volume 6| Issue 1: Jan-Feb 2025, Pages 91-98, URL: https://www.ijscia.com/wp-content/uploads/2025/01/Volume6-Issue1-Jan-Feb-No.827-91-98.pdf
Volume 6 | Issue 1: Jan – Feb 2025
